Endocrine Abstracts

While low testosterone levels are associated with higher incidence of type 2 diabetes mellitus in males. In contrast, hyperandrogenism is associated with higher risk of type 2 diabetes mellitus in females.

We, therefore, have assessed alterations in beta-cell functions before and after testosterone replacement therapy in male patients with idiopathic hypogonadotropic hypogonadism (IHH) and before and after anti-androgen therapy in patients with polycystic ovary syndrome (PCOS). The study population consisted of 17 female patients with PCOS, 15 appropriate controls and 33 patients with IHH, 30 appropriate controls. Patients with IHH were treated with intramuscular injections of chorionic gonadotropin 1500 U twice in a week for 6 months. Patients with PCOS were followed during treatment of 0.035 mg ethinylestradiol/2 mg cyproterone acetate combined pills (DIANE-35 tablet^®) for six menstrual cycles.

After 6 months treatment with antiandrogen in patients with PCOS, levels of total testosterone (TT), free testosterone (fT), fasting plasma glucose (FPG), 2-hour post-challenge glucose, 2-hour post-challenge insulin, c-peptide, and amylin concentrations decreased significantly. Antiandrogen treatment did not cause alteration in body mass index, Waist/Hip ratio, HOMA-IR, fasting insulin, proinsulin and amylin levels. Fasting plasma levels of TT, fT, proinsulin, c-peptide, and amylin increased, but fat mass, HOMA-IR and FPG decreased significantly in patients with IHH after chorionic gonadotropin replacement therapy.

Androgen replacement may increase beta cell dysfunction despite increase in insulin sensitivity and antiandrogen treatment may restore beta cell dysfunction in patients with PCOS.